The outcomes for women planning a VBAC at a private hospital in Australia

IF 2.8 3区医学 Q1 NURSING

Birth-Issues in Perinatal Care Pub Date : 2024-01-11 DOI:10.1111/birt.12811

Julieanne Chu MD, BMedSci, Hazel Keedle PhD, RM, RN, Kerry Sutcliffe PhD Candidate, MPhil, BSci, Norman Blumenthal MBBCh, FCOG(SA), FRANZCOG, Kate Levett PhD, MPH, BEd (Health) Hons

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引用次数: 0

Abstract

Background

Rates of cesarean birth (CBs) are steadily increasing and account for 36.7% of all births in New South Wales (NSW), with primary cesareans driving the increase. NSW Health guidelines recommend women attempt a vaginal birth after a previous CB (VBAC); however, rates of VBAC are decreasing, particularly within the private hospital setting. This study aimed to determine the rates of adverse outcomes for women who planned a VBAC (pVBAC) compared with women who planned an elective repeat CB (pERCB) at one private hospital in Sydney, Australia.

Method

This retrospective data review evaluated patient records over a 10-year period (2010–2019). Records (n = 2039) were divided into four groups: pVBAC, pVBAC + EMCB, labor + ERCB (lab + ERCB), and pERCB. The incidence of adverse maternal and neonatal outcomes is reported as counts and percentages. Regression and chi-squared tests were used to compare groups. Significance was determined at a p-value of <0.05.

Results

Overall, very low rates (N = 148, 7.3%) of women had a VBAC compared with a repeat CB at this private hospital over the 10-year period. The incidence of adverse outcomes was low regardless of study group. Outcomes differed significantly between groups for postpartum hemorrhage (pERCB seven times less likely than VBAC group) and special care nursery admission (pVBAC + EMCB is 4.6 times more likely than in the VBAC group).

Conclusion

Overall, it is safe to attempt a VBAC at this private hospital, and labor after a cesarean should be recommended, yet very few women had a VBAC at the study site. The incidence of adverse outcomes was low compared with other published research.

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澳大利亚一家私立医院计划进行剖腹产的妇女的结果。

背景：在新南威尔士州（NSW），剖宫产率稳步上升，占所有新生儿的 36.7%，其中主要是初次剖宫产。新南威尔士州卫生指南建议妇女在剖宫产后尝试阴道分娩（VBAC）；然而，VBAC 的比率正在下降，尤其是在私立医院环境中。本研究旨在确定澳大利亚悉尼一家私立医院中计划 VBAC（pVBAC）与计划选择性重复 CB（pERCB）的产妇的不良后果发生率：这项回顾性数据审查评估了 10 年间（2010-2019 年）的患者记录。记录（n = 2039）分为四组：pVBAC、pVBAC + EMCB、分娩 + ERCB（实验室 + ERCB）和 pERCB。产妇和新生儿不良结局的发生率以计数和百分比的形式报告。组间比较采用回归和卡方检验。结果：总体而言，10 年间在这家私立医院进行 VBAC 和重复 CB 的产妇比例非常低（N = 148，7.3%）。无论哪个研究组，不良后果的发生率都很低。在产后出血（pERCB 的可能性是 VBAC 组的 7 倍）和入住特殊护理托儿所（pVBAC + EMCB 的可能性是 VBAC 组的 4.6 倍）方面，各组之间的结果差异很大：总体而言，在这家私立医院尝试 VBAC 是安全的，应推荐剖宫产后分娩，但在该研究地点进行 VBAC 的产妇很少。与其他已发表的研究相比，不良后果的发生率较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth-Issues in Perinatal Care 医学-妇产科学

CiteScore

4.10

自引率

4.00%

发文量

审稿时长

>12 weeks

期刊介绍： Birth: Issues in Perinatal Care is a multidisciplinary, refereed journal devoted to issues and practices in the care of childbearing women, infants, and families. It is written by and for professionals in maternal and neonatal health, nurses, midwives, physicians, public health workers, doulas, social scientists, childbirth educators, lactation counselors, epidemiologists, and other health caregivers and policymakers in perinatal care.